Three weeks ago, my dentist placed a crown on an upper left molar. When I chew, the tooth touches the opposite bottom molar tooth, but it feels off. I think the crown needs deeper grooves so the other tooth will match it when I chew. If I ask my dentist to drill down some of the crown’s surface, will it damage it? I already told my dentist about the discomfort, and she told me that I need time to get used to my bite. How long will that take? Thanks. Geoff from Nebraska
Your dentist’s “give it time” response means that she doesn’t know what to do. Dr. Rota would need to examine your tooth and crown to determine what’s causing the disharmony with your bite. But the situation could be challenging to correct, or your dentist’s lack of knowledge might be the problem.
When you receive a new crown or onlay, your bite should be perfectly comfortable without you noticing the restoration. But the motions involved in chewing make the occlusion—how the upper and lower teeth fit together—complex. And many dentists aren’t skilled at getting it right.
Post-graduate institutes, including the Las Vegas Institute for Advanced Dental Studies, the Texas Center for Occlusal Studies, the Dawson Academy, the Pankey Institute, and others train dentists in the science of occlusion. Many cosmetic dentists attend the institutes or receive courses from other organizations that teach the same principles. Many other dentists feel that their dental school education was enough, and they don’t need additional training in occlusion. Although dentists who bypass additional training might complete single crowns or onlays, they may not be qualified to complete a full-mouth reconstruction. And if correcting your bite isn’t achieved with what they learned in dental school, they may not be able to do it. And as a patient, you’ll be told that it takes time to get used to it.
What Is Malocclusion and What Problems Can It Cause?
Malocclusion is the term for disharmony in the way your upper and lower teeth line up. Malocclusion, or misaligned teeth, are caused by the shape, size, or position of your jaw or teeth. The shape and size of a dental crown can affect your bite. Although you might get used to the way your bite feels, it doesn’t mean that it’s aligned correctly. And malocclusion can lead to other issues.
- Unusual stress on teeth – The stress can lead to bone loss around the affected teeth.
- TMJ disorder – You might experience symptoms or signs related to TMJ, including jaw, facial, or neck pain, and headaches or earaches.
Many dentists adjust a new crown or onlay by asking you to bite on bite registration paper. The paper leaves marks where the crown or onlay makes contact prematurely. The dentist will grind down the crown in those places. Your dentist has probably completed that essential step, and your crown isn’t high.
The issue with your bite is more subtle. But a dentist—maybe not your dentist—can adjust the crown to make it comfortable without damaging it. If your dentist doesn’t know how to correct it, you can wait a few months to see if the tooth begins to feel better with your bite. Or you can get a second opinion from an advanced cosmetic dentist. Look on a few dentists’ websites for information about post-graduate training in occlusion in one of the institutes mentioned above or in another program, and schedule an appointment for a second opinion.
Joseph Rota, DDS, an award-winning cosmetic dentist in Colorado Springs, sponsors this post. Dr. Rota is a graduate of the Las Vegas Institute for Advanced Dental Studies.